CHICAGO —A new approach to lung cancer: From diagnosis to treatment, all in one day.
It’s typically a nerve-wracking delay. You’re told you have a suspicious spot but may have to wait months for a definitive diagnosis and treatment. A local team of doctors wants to make the process more immediate, diagnosing and operating on lung cancer patients the same day.
Achille Caringella has been baking his whole life. His family operated a pizzeria. In his 30s, he was diagnosed with asthma, a condition that’s persisted.
“The allergist said, you have ‘Baker’s Asthma. It compromises your immune system, so you are more susceptible to infections,’” he said.
Now at 72, he’s facing another health threat.
Dr Samuel Kim is a thoracic surgeon. He’s part of a program called A-PLUS, Ambulatory Precision Lung-Sparing Surgery.
“Our patient is able to get a proper diagnosis, treatment and going home same day,” Kim said.
More than 200 a-plus cases have been performed at Northwestern Medicine.
The robotic procedure begins by placing multiple ports including a camera, that will lock on to mechanical arms.
The instruments are used to sample suspicious nodules and the tissue is sent to a lab for evaluation as surgeons wait. If it comes back positive, the procedure continues to remove all cancer.
For Caringella, the team targeted a lesion during the procedure, then working from a control console, Kim first removed lymph nodes that will also be biopsied to make sure the cancer hasn’t spread.
If cancer is found in the lymph nodes, he will require chemotherapy.
“What this instrument does not only it burns a little blood vessel, at the same time it dissects and coagulates so it kind of seals up bleeding,” Kim said.
He dissects blood vessels that feed the tumor and supply the section of lung he’s removing. Two hours later, two-thirds of Caringella’s upper right lung lobe is out along with the cancer.
The specimen will be taken to pathology, so the stage of disease can be confirmed.
More about Northwestern Medicine’s A-PLUS Program
“We’ll have to know more about it once all the lymph nodes I took out come back from the final analysis, which will be about 7 to 10 days from now,” he said.
Once all the instruments are removed Kim and his team close the incisions.
“Think about the patient and the family members who are anxiously waiting for the lung nodule diagnosis and treatment,” he said. “As long as pain level is ok and lung continues to be sealed up he should be able to go home today.”
And that’s exactly what happened. Caringella went home later that day. He says he’s feeling good.
Kim says he was able to remove all cancerous tissue in the lung and save about 10 percent of Caringella’s lung function by doing the lung-sparing procedure.